Hematic Content Research Articles

Maxillary Aneurysmal Bone Cyst: About a Case

Introduction: Aneurysmal bone cyst (ABC) is a primary or secondary benign tumor, consisting of an intraosseous cavity, uni or multilocular, with hematic content. It can develop on all bones of the skeleton with, however, a predilection for the long bones and the spine. KOA mainly affects children and young adults, with a slight female predominance. Objective: The aim of this work is to reveal the diagnostic features at the imaging level. Case Report: This is an 11-year-old female patient with no previous pathological history who has presented for 1 year with diffuse maxillofacial pain, with intermittent fluid discharge in the oral cavity. Facial CT scan without and with contrast injection objective a lytic image centered on the lateral wall of the left maxillary sinus bulging into the sinus lumen with a spontaneously hypodense multicompartmental appearance without contrast gain after PDC injection. Conclusion: KAO is a very polymorphic lesion, which presents a diagnostic problem (Aspecific radiological appearance). In spite of the different therapeutic modalities proposed, it is the surgical treatment which exposes less risk of recurrence.

Lymphangioma Circumscriptum Mimicking a Supernumerary Nipple

Cutaneous lymphangioma circumscriptum is an uncommon congenital malformation of the superficial cutaneous lymphatic vessels. They appear as vesicles, with clear or hematic content as well as plaques with a smooth or hyperkeratosic surface. We report the case of lymphangioma circumscriptum with a supernumerary-like clinical presentation

Hemorrhagic abdominal pseudocyst following ventriculoperitoneal shunt: a case report

BackgroundAbdominal cerebrospinal fluid (CSF) pseudocyst is an uncommon but important complication of ventriculoperitoneal (VP) shunts. While individual articles have reported many cases of abdominal CSF pseudocyst following VP shunts, no case of a hemorrhagic abdominal pseudocyst after VP shunts has been reported so far.Case presentationThis article reports a 68-year-old woman with a 4-month history of progressive abdominal pain and distention. She denied any additional symptoms. A VP shunt was performed 15 years earlier to treat idiopathic normal pressure hydrocephalus and no other abdominal surgery was performed. Physical examination revealed an elastic palpable mass in her right lower abdomen, which was dull to percussion. Abdominal computed tomography (CT) scan indicated a large cystic collection of homogenous iso-density fluid in the right lower abdominal region with clear margins. The distal segment of the peritoneal shunt catheter was located within the cystic mass. Abdominal CSF pseudocyst was highly suspected as a diagnosis. Laparoscopic cyst drainage with removal of the whole cystic mass was performed, 15-cm cyst which found with thick walls and organized chronic hematic content. No responsible vessel for the cyst hemorrhage was identified. No further shunt revision was placed. Histological examination showed that the cyst wall consisted of outer fibrous tissue and inner granulation tissue without epithelial lining, and the cystic content was chronic hematoma. The patient had an uneventful postoperative course and remained asymptomatic for 8-mo follow-up.ConclusionTo the best of our knowledge, this is the first report of hemorrhagic onset in the abdominal pseudocyst following VP shunt. Such special condition can accelerate the appearance of clinical signs of the abdominal pseudocyst after VP shunts, and its mechanisms may be similar to the evolution of subdural effusion into chronic subdural hematoma (CSDH).

Paraneoplastic Pemphigus in Patient with Cervical Epidermoid Carcinoma: A Case Report

A 34-year-old man complained of mouth sores of 4 months' duration. His medical history showed a diagnosis of epidermoid carcinoma in the left cervical region and treatment with chemotherapy (gencitabine 1500 mg and cisplatin 45 mg) and radiotherapy (70 Gy fractioned in 35 sessions). Extraoral examination revealed vesiculobullous lesions on skin. Nikolsky sign was positive. In the oral cavity, painful ulcers were observed in the tongue and cheek mucosa bilaterally. Incisional biopsy was performed on the lateral border of the tongue, and histologic sections stained with hematoxylin and eosin showed a segment of squamous mucosa showing a subepithelial bulla filled with amorphous material with no leukocyte or hematic content. Based on the clinical and histopathologic characteristics, a diagnosis of paraneoplastic pemphigus was established. Treatment is in progress using prednisone (60 mg/day) with dapsone (50 mg/day), resulting in improvement of oral and dermatologic lesions after 3 weeks.

Unilateral renal agenesis and uterine anomalies: how and when can we make this diagnosis?

A 12-year-old female with a prenatal diagnosis of left kidney agenesis was hospitalized with a history of four months of recurrent abdominal pain and dysmenorrhea after menarche. Imaging investigation revealed a gynecological malformation associated with Mullerian developmental defects – duplicated uterus with an obstructed left hemi-uterus filled with hematic content (haematometra), one cervix and a normal vagina. We pretend to alert pediatric physicians about the association of renal agenesis and gynecological malformations, most frequently uterine, but also vaginal. Early detection of these malformations by imaging will anticipate therapeutic measures to relieve symptoms, mostly recurrent abdominal or pelvic pain, and to avoid complications such as endometriosis, pelvic adherences and infections.

Angina bullosa hemorrhagica an enigmatic oral disease

Angina bullosa hemorrhagica (ABH) is an enigmatic oral disorder described for the first time by Badham in 1967 to define blisters with a hematic content in the oral cavity and oropharynx unrelated to any hematological, dermatological or systemic disease. The ABH is an uncommon disease of the oral cavity distinctively affecting adults, with the highest incidence over the 5 decade of life. This process is considered nowadays to have a multifactorial etiopathogenesis, where mild oral traumatisms can trigger the blisters in susceptible individuals. Certain association on the onset of the lesion with the chronic use of inhaled steroids and, more controversially, with triggering systemic disorders, such as, diabetes or hypertension has been described. Characteristically, the ABH blisters are acute and are located on the lining mucosa, more frequently on the soft palate. Usually, the lesions are solitary and rupture easily, resulting in a superficial ulceration that heals quickly without scarring. The histopathological analysis shows a subepithelial blister containing blood and direct immunofluorescence on the epithelium is negative. The differential diagnosis should consider all oral vesiculobullous disorders with hematic content, including mucocutaneos, hematological or cystic pathology. The diagnosis of ABH is clearly clinical, although the biopsy might be helpful on atypical or abnormally recurrent cases. The general prognosis of ABH is good and the treatment is symptomatic.

Adenocarcinoma of rectum metastatic to eye: report of case

A 64-year-old man with a history of low grade adenocarcinoma of rectum 2 years previously, presented with decrease of the visual field of the left eye. Examination revealed an intraocular tumor located at the posterior pole and total retinal detachment. The patient was submitted to an enucleation. In the macroscopy, to the serial sections was observed an exophytic tumor of light brown color of 2 × 1.4 × 7 cm, located in posterior chamber with hematic content. Histopathology showed infiltration by tubular moderately differentiated adenocarcinoma of intestinal type, which compromised the vitreous chamber, retina, choroid and partially infiltrated the sclera, exceeded the lamina cribrosa and invaded the optic nerve. The neoplastic cells were positive for CDX-2. The intraocular metastasis is preferably located in the choroid being more frequently adenocarcinomas from the lung and breast and being very rare metastatic adenocarcinomas from colon or rectum. A 64-year-old man with a history of low grade adenocarcinoma of rectum 2 years previously, presented with decrease of the visual field of the left eye. Examination revealed an intraocular tumor located at the posterior pole and total retinal detachment. The patient was submitted to an enucleation. In the macroscopy, to the serial sections was observed an exophytic tumor of light brown color of 2 × 1.4 × 7 cm, located in posterior chamber with hematic content. Histopathology showed infiltration by tubular moderately differentiated adenocarcinoma of intestinal type, which compromised the vitreous chamber, retina, choroid and partially infiltrated the sclera, exceeded the lamina cribrosa and invaded the optic nerve. The neoplastic cells were positive for CDX-2. The intraocular metastasis is preferably located in the choroid being more frequently adenocarcinomas from the lung and breast and being very rare metastatic adenocarcinomas from colon or rectum.

Acute urinary retention caused by OVHIRA syndrome

Obstructed hemivagina and ipsilateral renal anomaly (OVHIRA) syndrome is a congenital urogenital malformation that associates a bifid uterus with a longitudinal vaginal septum, resulting in a blind hemivagina and an ipsilateral renal agenesis. The clinical presentation is highly variable, delaying diagnosis and leading to important complications. An 18-year-old woman was diagnosed with OVHIRA syndrome following acute urinary retention. An agenesis in the left-sided renal system and an enormous pelvic mass compressing the adjacent structures were revealed in the intravenous urography. Nuclear magnetic resonance was the imaging modality that provided most diagnostic information, defining the pelvic mass as a giant left hematometrocolpos contained with a longitudinal vaginal septum. Resection of the septum was performed draining all reduced hematic content and both hemiuteri communicated with a single vagina, resulting in an asymptomatic patient. OVHIRA syndrome is a little known entity that can occur atypically, which makes the diagnosis difficult and delays the treatment. It is important to maintain a high degree of clinical suspicion to avoid irreversible complications.

Diagnosis of Heterotopic Pregnancy Using Ultrasound and Magnetic Resonance Imaging in the First Trimester of Pregnancy: A Case Report

Heterotopic pregnancy is a condition characterized by implantation of one or more viable embryos into the uterine cavity while another one is implanted ectopically, particularly into the uterine tube. Its occurrence has increased drastically over the last few years due to assisted reproduction procedures. In general, the diagnosis is made during the first trimester by using endovaginal two-dimensional ultrasound (2DUS), through observing a complex para- or retrouterine mass in association with a viable uterine pregnancy. However, under some conditions such as atypical ultrasonographic presentations, 2DUS does not clarify the situation whereas magnetic resonance imaging (MRI) of the pelvis is able to do so. We present the case of a pregnant woman in her fifth pregnancy, with a clinical condition of lower abdominal pain and pallor. Endovaginal 2DUS showed a complex voluminous mass in the left pelvic region in association with a viable intrauterine pregnancy. 2DUS in power Doppler mode showed “ring” vascularization, compatible with an ectopic gestational sac. MRI was of great importance in that it suggested that the mass had hematic content, which together with the clinical features, indicated that laparotomy should be performed. This surgical choice was essential for the woman to achieve a clinical improvement and for good continuation of the intrauterine pregnancy.

Hot Hypertonic Saline and Compression Device: A Novel Approach in Preventing Severe Hemorrhage during Extirpation of Deep Vascular Malformations of the Face.

Background:Hemorrhage is a serious challenge in vascular malformations (VMs). This problem makes the surgical excision of the lesions difficult and sometimes impossible.Objective:The objective was to design a technique that will meet with the challenges of hemorrhage while performing surgery in such lesions in our environment.Patients and Methods:Seven patients with deep and moderately large VMs of the facial region were selected and treated with hot 7.5% hypertonic saline after compressing the feeder vessels. This was then complemented with surgical excisions.Results:There were successful surgical extirpations of the lesions without eventful hemorrhage.Conclusion:Hot 7.5% hypertonic saline injected into VMs after emptying their hematic content caused sclerosis of the anomalous vessels. This made bleeding during surgery uneventful.

Dermoscopic Features of Cutaneous Lymphangioma Circumscriptum

Cutaneous lymphangioma circumscriptum (CLC) is clinically characterized by clusters of translucent vesicles that may be filled by blood. To evaluate the dermoscopic features of CLC. Dermoscopic examination was performed in two cases presenting with discrete translucent and blood-tinged lesions. Lesions filled with clear fluid were dermoscopically characterized by light brown lacunas surrounded by paler septa. Lesions tinged with blood were associated with different dermoscopic features depending on the amount of blood content: focal reddish areas inside the lagoons, pink diffuse coloration, reddish to violaceous lacunar structures. On dermoscopy, CLC was characterized by a lacunar pattern. Lesions with a marked hematic content show dermoscopic findings indistinguishable from those of hemangioma.

Hemorrhagic adrenal pseudocyst: laparoscopic treatment

The incidence of adrenal hemorrhagic pseudocyst is very low. A total of 613 adrenal cysts and 85 hemorrhagic pseudocysts have been reported. A laparoscopically diagnosed and resolved case is presented here, together with the current diagnostic and therapeutic procedures. A 40-year-old woman was admitted because of an asymptomatic nonfunctional right adrenal tumor. Right laparoscopic adrenalectomy was performed, 8-cm cyst which found an with thick walls and organized hematic content. The postoperative course was uneventful. Follow-up was 14 months. The pathology was an adrenal hemorrhagic pseudocyst. A total of 56% of adrenal cysts are pseudocysts. One third of them have hematic content. They may present as an asymptomatic finding with nonspecific symptoms or as a hormone secreting or complicated tumor. Their vascular etiology is not yet totally accepted. There is a tendency for intracystic bleeding. it is advisable to evaluate the hormonal profile and morphologic characteristics in all cases. Treatment options include needle aspiration, percutaneous drainage, and cyst or gland resection. Laparoscopic excision should be evaluated.

Hamartoma of the mitral valve with blood cysts: A rare tumor detected by echocardiography

A 16-year-old boy was submitted to a cardiac examination after an episode of faintness. A transthoracic echocardiogram was performed, which revealed a very mobile multicystic tumor attached to the mitral valve. A small solid mass adherent to the cysts was better defined by transesophageal echocardiography. The patient was submitted to cardiac surgery consisting of tumor resection and a mitral prosthesis implant. The surgery was successful. The tumor consisted of three bright red tense cysts with hematic content, each 1 to 2 cm in diameter. The cysts were coalescent and adherent to a solid mass attached to the posterior papillary muscle head. Histopathologic examination revealed a hamartoma with a cystic part composed of the proliferation of myofibroblast cells in a stroma with vessels, collagen, and elastin fibers. Valvular hamartoma with blood cysts is a very rare cardiac tumor both for its histopathology and its localization. (J Am Soc Echocardiogr 1998;11:832-6.)

Tonal Plan and Narrative Plot in Tchaikovsky's Symphony No. 5 in E Minor

This article explains the large-scale tonal plan of Tchaikovsky's Fifth Symphony in terms of a dialectic between two keys, E and D. The work's thematic content and process define its narrative plot, which follows the familiar strife to victory archetype of Beethoven's Fifth Symphony. The ensuing discussion demonstrates the interaction of tonal plan, thematic materials, and emotional narrative, with reference to specific musical details. ressive narrative of the work-an exampl f the strife to ictory plot archetyp , defined by hematic content and rocess. In reviewing the analytical lot of this paper, it s int resting o note that a consideration of the emotional a rative of the first movement led to the recognition of D ajor s a ca alyst (rather than a simple antagonist) in the onal plan. Perhaps a lesson may be drawn from this seuence of events: a strateg of analytic l give and take etween musical structure and modes of expression has much o o fer us as we strive t enrich our understanding and njoyment of symphonic music-indeed, of all music-from I This content downloaded from 157.55.39.215 on Wed, 31 Aug 2016 05:13:16 UTC All use subject to http://about.jstor.org/terms